In 2010, Hultzen was named ACC Pitcher of the Year. He is the first Virginia Cavalier to win the award.[2] He was also named First-Team All-ACC a second time. Over the 2010 season, Hultzen finished with a 10–3 record and an ERA of 1.59 in 961⁄3 innings. In 2011, Hultzen won the John Olerud Award, awarded annually by the College Baseball Foundation to the best two-way player of the season.[3]

Hultzen missed the majority of the 2013 season due to a shoulder injury. After the 2013 season, he underwent surgery to repair a torn labrum and rotator cuff in his shoulder, and missed the entire 2014 season.[6]

Hultzen will sit out the 2017 season, partially because he is returning to the University of Virginia to finish his university degree, and will attempt a professional baseball comeback in 2018.[7]

Hultzen struggled with his control in AAA in 2012, walking 43 hitters in 482⁄3 innings.[10] Addressing those concerns, Hultzen said, "You need to learn how to fail in this game ... I haven't faced a lot of failure as a pitcher. You need to learn how to cope with it, and I think I have. Hopefully most of it is behind me."[9]